The effect of heart transplantation on mortality in end-stage heart failure patients with UNOS status 2 [UNOS 2 statüsündeki son dönem kalp yetersizligi hastalarinda kalp naklinin mortaliteye etkisi]
Küçük Resim Yok
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objectives: Despite recent developments in medical treatments and assist device applications, management strategies for end-stage heart failure patients with UNOS status 2 (United Network for Organ Sharing) are still controversial. We evaluated the clinical condition and prognosis of end-stage heart failure patients with UNOS status 2, who were placed on the waiting list for heart transplantation. Study design: The study included 78 patients (62 men, 16 women; mean age 43±12 years) with UNOS status 2. The patients were assessed in terms of frequency of hospitalization during waiting for transplantation, shift to a higher level of UNOS status, transplantations performed, and mortality. Results: The mean duration of waiting on the list was 17±10 months. The frequency of hospitalization due to heart failure was 4±2/year. An implantable cardioverter defibrillator was used in seven patients (9%) for persistent ventricular tachycardia. Nine patients (11.5%) shifted to UNOS status 1B. Eighteen patients (23.1%) underwent orthotopic heart transplantation following six months of waiting on the list. Mortality rates were 25% (n=15) and 22.2% (n=4) for patients on the waiting list and for transplant patients at the end of the first year of transplantation, respectively (p=0.03). The main cause of mortality was sudden cardiac death (73.3%, n=11) for patients on the transplantation list. There was a significant difference in terms of combined end-point of mortality and shift to UNOS status 1B between transplanted (n=24, 40%) and untransplanted (n=4, 22.2%) patients (p=0.01). Conclusion: Heart transplantation is an appropriate alternative for preventing impending clinical deterioration, frequent attacks of heart failure, and cardiac deaths in patients with UNOS status 2.
Açıklama
Anahtar Kelimeler
Death, sudden/etiology, Heart failure, congestive, Heart transplantation, Patient selection, Waiting lists
Kaynak
Turk Kardiyoloji Dernegi Arsivi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
34
Sayı
8
